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Discussion Starter · #1 ·
Hi ladies,

Feeling a bit down after my latest cycle failure. As you can see from my signature, I'm a really poor responder - seem the most I ever get is 2 eggs on the left ovary and no response at all from the right. We got the dreaded call yesterday saying that neither egg had fertilised as they were immature  :'(. I was so gutted - especially since I'd been on 250iu menopur and 150iu gonal-f, which is the highest does my clinic will prescribe.

We have one more free go at this but I don't really hold out much hope given my previous track record. Before this failure, we'd assumed that it was just a numbers game and we'd just keep going until I eventually get that BFP. Now I realise that its not just going to be a matter of luck for me - I just don't produce enough eggs. DH is keen to keep on trying with my eggs anyway, but I don't think I can handle the stress of a) hoping to produce any eggs at all despite the high medication and b) waiting to see if they fertilise. I'd rather put all our eggs in the one basket (so to speak) and go for donor eggs after our free goes are exhausted.

It's a tough decision considering 1 donor egg cycle costs the same as 3 more cycles using my own eggs. Still - it a risk I'm willing to take!

I guess what I'm after here is a happy ending story.. have any serial poor responders gone to donor eggs and had success?

I know it sounds hopelessly naive now, but I'd just kind of assumed when we started tx that I would easily get pregnant through ivf since I'm fit and healthy and have never had anything wrong with me. Boy, was I wrong!

x
 

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Hi Blue,

We cycled together on the Feb thread and I see that since then you have unfortunately had another failed cycle - so sorry to hear that and the circumstances.

I am not in the same situation as you, and so don't have any particular insight with regards to poor responders, but I guess I wanted to reply just to share my thoughts, for what they are worth...

I read recently that one of the fertility docs had said that he held the view that whilst a women produces her own eggs there is always hope and they would continue to offer tx in these circumstances.

I have also heard people say (and I do have some experience of this), is that it might help to move to a different clinic and try something new.  Your drug levels may be the highest that your clinic offers, but others may offer more or a different regime/mix of drugs, or more specialised treatment for poor responders.  I have recently moved clinics and although I am still in early stages of new clinic experience I feel this already is a good move for me.

Also although you have not responded that well on your last few treatments, cycles can vary and I do wonder if you would do well to have a little break before trying again.  Now I say this and yet I know myself that I was desparate to cycle straight away after my failed treatment, and I think I can recall asking you how you had managed to get the clinic to go again with no gap...but my new clinic have basically said that I should wait till the third month after last treatment, and although I didn't want to hear this, I do now think as the time for my next tx nears that this is good advice and that the body does need a little time to get the drugs out of the system before trying again.  Almost like a clean slate.  The lateness of my last AF when I am normally a bang on 28 dayer, proved to me that the body must require some recovery time.  Also the emotional compound factor of treatments close together I think could heighten the despair.  Again, I didn't see this to start with, I kept thinking it will be worse for me to wait because I am panicing about my age (I too am 38), but in the end I think the little break has done me good and I can see that had I had another failed treatment straight away on top of the last one, it could have cracked me up completely.

THe only other thing I would add is to ask whether you have had AMH or Antral Follicle Scans to see what your reserve might be?  You might have done all that and bought the t shirt so to speak, so this may not help, but if not it may help you reach a decsion about DE more definitively.

Good luck with whatever you do Blue, and remember not to give up hope - there are so many stories of ladies just like you that have ended up with a positive outcome and there is no reason that whilst you have a few little eggies left that you cannot add to that statistic.

Yellow xx
PS - just to illustrate that, my last clinic told me that they had just had a lady that had only one egg retrieved which fertilised, was transferred and resulted in a BFP, and this is a clinic with not that great a set of results!
 

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Discussion Starter · #3 ·
Hi Yellow  :)

I think you're right - a break will do me good. After the last cycle, all I could focus on was getting started again ASAP and my clinic didn't have a problem with that. Now that it seems apparent that I hardly respond to treatment even at really high doses, I'm really happy to take a break, get all that medication out of my system and find out as much information as I can regarding both the physical reasons why I'm not responding and the options that remain open to us.

I haven't had AMH or anything else tested, so that is on the top of our priority list. I think in some way it will also give me piece of mind about our actual situation so that we can plan more carefully, rather than just relying on the blind hope we had when we started this journey.

Do you know when your next cycle will be? I wish you all the very best for it and I look forward to hearing how you get on  ^hugme^

Blue x
 

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Hi Blue

I have had similar response to drugs as you but before we go down the egg donor route my consultant has suggested mild ivf. I only get a few eggs on high stims so the theory is I will (hopefully) get same number of eggs on clomid (or something similar) & possibly better quality.  I've not yet looked into this as we are on a break for a few months too. To help with stress I definitely recommend acupuncture.

Good luck x
 

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Hey Blue

So sorry to hear your news.  One thing I would say is that I am classed as a poor responder.  On my last cycle I was prescribed 450 iui of Menopur and got 5 follies from which they got 5 eggs, 3 of which were mature and fertilised.

I'm waiting to see what happens on my current cycle - they are taking an entirely different approach and I'm on different levels of varying drugs each day.  I should have EC in about a week so I'll let you know how I get on.

I'd say that before you give up, you really should find a different clinic.  It really does not sound like the clinic you're at is giving you the best advice.

^hugme^  Whatever you decide to do, just know that there are other clinics out there that will help you and give you the right medication.

xxx
 

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Hi Blue,
I am with Yellow - I was given the same advice from my consultant re waiting 3 months. He said if you cycle earlier then the ovaries just don't absorb the drugs so well so you get a poor response. He said they need time to recover. I presume the length of time will depend on the amount of drugs in your system. I was on a really high dose.. 300 Gonal F. 150 seems very low for their highest dose! some girls ar on 400! (Mind you I don't know anything about the menopur mix as I was always straight Gonal F).
I also agree with Mandy there are so many different protocols that can be tried. Some have more downsides than others (e.g. clomid is very cheap but can cause cycts and it thins your lining so helps follies grow but does not help implantation, and the other drugs with increased doses get much more expensive..!) It is very odd that your clinic didn't do an AMH test - I am pretty sure that the results of the AMH test have a pretty big influence on the protocol and drugs dose that is best for you.
Getting an AMH test and going to a clinic that specialising in treating in your AMH range sounds like a very good way forward.
good luck!  :)
 

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Hi ladies

I'm in the same boat as you - 2 eggs at last EC, both fertilised but a BFN. Our consultant has recommended only one more attempt with our own eggs before we consider DE. He explained it to us as 1 IVF cycle would be the equivalent to us trying naturally for about 8 months as the only advantage of IVF for us is the choice of the best embryo.

Based on this my DH is not keen on trying IVF again just yet, he want's us to give it a go naturally for a year to see if we can do it ourselves. In a year i will be 36!!!! Time is not on our side.

I'm with you Bluemaomao, I would like to try DE, but DH will not really even consider it at the mo. I feel like my eggs are so rubbish that we should just give up on them and try something new. We only had 1 free IVF so funding is an issue, but I know that isn't the reason why DH isn't keen. :-\

Meemee - I like the idea your consultant has re clomid. I'd be really interested to hear how that goes for you. :)
Mandypandy - I hope this cycle goes well for you and I hope that stimms has gone well so far. ^reiki^
ElsieF - You comment on clomid is interesting - I wasn't aware that it thinned linings - as the thickest mine has ever been is 5.6mm I guess that wouldn't be good for me to try. :(

I have just ordered some DHEA to try. Our consultant recommended trying it as a "last hope" to improve egg quality. We'll be using it from
next cycle. Does anyone here have any experience of using it?

Anyway, ladies I am so glad I have found you as I suddenly don't feel so alone.

Thankyou!!!!!
 

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Hi Amethyst,
If you have a look at the mini ivf protocols (developed in the US) you can see that they do EC, then freeze the embryos and wait a couple of months before doing ET so that the lining is recovered and any cysts that have been developed can be removed. I did quite a lot of research into this protocol last year. I respond ok to the high doses of Gonal F I take  :eek:  but thought the idea of less drugs had to be a good one!  But after speaking to my consultant (at some length!) about all the pros and cons, I decided against it.
It then made me think that the US clinics could well be responding to US medical insurance policies which often cover IVF treatment but not the drugs. The mini IVF protocol has increased medical costs as they do both IVF + FET, (often paid to the clinic by the insurance companies)  but only about 100$ drugs costs (paid by the patient). The regular protocols which would be less  medical costs of IVF only, and drugs costs of 1,000+$. But then I admit I am a skeptic when it comes to these things! ( I wouldn't blame the clinics by the way, as in this business nothing is certain, so if a low cost solution can be found for the patient then why not try it! but if you don't have US insurance then it is not a low cost solution!)
Sorry your DH is not jumping at the DE solution. Maybe he just needs some time to get his head around it. My  DH doesn't like it either, but has now come round to the idea because of a) not wanting to see me go through any more heartbreaking treatments, and b) because he also really wants a baby.

^fairydust^  to us all!





 

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amethyst_uk said:
Hi ladies

I'm in the same boat as you - 2 eggs at last EC, both fertilised but a BFN. Our consultant has recommended only one more attempt with our own eggs before we consider DE. He explained it to us as 1 IVF cycle would be the equivalent to us trying naturally for about 8 months as the only advantage of IVF for us is the choice of the best embryo.

Based on this my DH is not keen on trying IVF again just yet, he want's us to give it a go naturally for a year to see if we can do it ourselves. In a year i will be 36!!!! Time is not on our side.

I'm with you Bluemaomao, I would like to try DE, but DH will not really even consider it at the mo. I feel like my eggs are so rubbish that we should just give up on them and try something new. We only had 1 free IVF so funding is an issue, but I know that isn't the reason why DH isn't keen. :-\

Meemee - I like the idea your consultant has re clomid. I'd be really interested to hear how that goes for you. :)
Mandypandy - I hope this cycle goes well for you and I hope that stimms has gone well so far. ^reiki^
ElsieF - You comment on clomid is interesting - I wasn't aware that it thinned linings - as the thickest mine has ever been is 5.6mm I guess that wouldn't be good for me to try. :(

I have just ordered some DHEA to try. Our consultant recommended trying it as a "last hope" to improve egg quality. We'll be using it from
next cycle. Does anyone here have any experience of using it?

Anyway, ladies I am so glad I have found you as I suddenly don't feel so alone.

Thankyou!!!!!
Thank you!

Re: your consultant saying you should have DE, did s/he say why? If you got 2 eggs that fertilised, then there is nothing wrong with your eggs at all - it could just be an implantation issue and DE won't solve that.

I have used DHEA before and I would just say: be careful. I took it because my AMH was 6.6. After 4 months, my AMH was 2.4 - and that was only on 25mg a day. There are conflicting opinions on it's success and it's generally recommended for women over 40. It can actually have the opposite effect of what you want and has some unpleasant side effects as it affects your testosterone and consequently your oestrogen levels. If you naturally produce enough testosterone, taking DHEA could make it worse. Just do some research on it before you start taking it, then you can make an informed decision as to whether or not to continue. Also, if your consultant has recommended it, ask them why, specifically, it would benefit you. What is it about your blood work, etc., that makes him/her think it is a good idea. I'd also recommend having your testosterone levels checked before taking it.
 

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Hi Blue,


I understand how you are feeling hun, I just had a BFN last week. It really is devastating. Like you, I am not a good responder, my clinic did AMH test before I started treatment and decided that as my AMH is only 3.39 (Low), it would be unlikely that I would respond using a long protocol IVF.


My consultant told me that for low AMH ladies, he recommends short protocol as down regging then stimulating the ovaries when you have low AMH can just result in the ovary 'giving up' and not responding.


My AFC showed I have 4 follicles on each ovary. During stimming, 7 of them responded, though at ec, only 5 were big enough. We got 5 eggs, 3 of which fertilized. But sadly, my 2 embies didn't make it when they were put back  :'( .


Maybe it would be a good idea to get the AMH test done, I think that the more we understand about the reasons we can't conceive, the more that can be done. It makes me feel sick to think that the clinic I originally was due to have tx at were just going to put me on long protocol and see what happened without any further tests....how many goes would we have wasted until they figured out that the treatment was wrong??


We are going to try again at the end of June, give me 2 months to recover (hopefully its enough) and then get on with our 2nd go. I am pleased that I did respond better than expected and hope that next time my embies implant.


I hope that next time you get a success story too xxx
 

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Mandypandy - I have just read your comment re my consultant recommending using an ED to my DH - he agrees with you totally and that is why he's not keen on the DE idea. I don't know why I hadn't seen that before. I think I am so involved with the low quality that I kinda missed that my lining is probably the real problem.
Maybe I won't give up on my own eggs just yet!

ElsieF - thanks for that advice on DHEA - I will look into it.

ekitten1 - sorry to hear about your BFN. I hope that you are looking after yourself. I agree with you about knowing the reasons why we can't conceive. How can we fix or deal with what we don't know about? It drove me mad when I did my IUI's (funded) as no-one cared why we were doing it - it was very impersonal as if we were on a conveyor belt. Very frustrating. ::) :mad:
 

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Hi Amethyst - I think that the whole process of assisted conception is very impersonal and even though we had lovely nurses supporting us during the ec and et, it still felt unnatural and wrong....We watched our embies being released inside me on the scan screen and whilst it was amazing to see, it's not the way it should be done....Those couples who can have an intimate moment and conceive a baby naturally really don't know how lucky they are. To be honest though, right now I don't care how I conceive, whatever it takes, so long as it happens  ::) . I wish you loads of  ^reiki^ ^reiki^  and  ^pray^ ^pray^  for your next cycle xx
 

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Hi Blue,

I did reply to you the other day but response not there and website seems to have been playing up!  Irritating when you lose posts!!

Anyway, centiment of what I was saying was I think you should try and have any test that are appropriate to your situ, (AMH/AFC)  and build up your picture as best you can so that you can make whatever decisions fully informed (or as much of any of us can be).  I agree with other ladies around your drugs not seeming that high (although gonal/menopur mix probably does complicate things I think), but non the less you need to see what else is out there and I think a change of clinic could be the way forward.  I look back on old clinic versus this new one (which I have only partly experienced so far), but already I just feel that there suddenly seems so many more options available and avenues to try. 

AFM - I am awaiting results of the L1 & L2 (chicago) immune tests - get the results on 27th May and then hoping to start on that cycle in June.  I think because of our situ (unexplained for so long), I felt we had to see what else might be contributing to the issue, or at least rule out other problems.  I'm throwing the kitchen sink at it this time!!!

Good luck Blue (and others), I will keep an eye out on your progress too.
Yellow xx
 

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Discussion Starter · #14 ·
Hi ladies!

I haven't logged in for a couple of days - thanks for all your lovely replies!  :)

It's nice not to feel so alone. It's bad enough feeling like a loser in the 'pregnancy' world without feeling like one in the IVF world as well  ;D

I just realised that my first email was supposed to read 350iu menopur and 150 gonal-f  :-[

It's really interesting to hear all the advice that other people get - seems different wherever you go. After much research, I think I might push for short protocol on our next attempt. It's worth a try. I'll follow your progress Mandy!

The situation with my 'clinic' is a little odd. In the town I live (in Sweden) there's only one doctor that deals with IVF. He prescribes the medication and does the scans, but the clinic where the procedure takes place is about 90 minutes drive away. Unfortunately, the doctor has a terrible manner. It's almost impossible to get information out of him and he's very discouraging all the time. Now, even the thought of going to see him makes me anxious! Luckily though the actual clinic and the staff there are great. We've got an appointment to see them on thursday afternoon just to discuss what's happened so far, ask lots of questions, and hopefully be clearer about what to do next. I'm really looking forward to getting some answers!

Blue x
 

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Blue - have you considered/are you able to come over to the UK for a cycle (I'm sure you probably have thought about it)?  Now that I'm at ARGC, I've met a lot of ladies who come from all over for treatment.  A lot of them take between 2-4 weeks off and stay in London while they're undergoing treatment.  Could that be a possibility for you?

Amehtyst - I mentioned it only because it's an issue close to my heart.  My AMH dropped to 2.4pmol/l and the consultant straight away said we would have to look at donor eggs - without even having undergone a tx cycle!  I was devastated but said that I would like to try my own first, which we did and they were fine!  There might have only been 3 good ones but they all fertilised and went on to become high quality embies.  Unfortunately the cycle didn't work but I've since had all kinds of tests done and I have Hashimoto's, low progesterone and other immune issues, so those poor little embies never stood a chance.  I was fuming as my consultant never tested for any of it (despite me asking him to). For this cycle we've moved to ARGC and are getting what will hopefully be the right treatment (lord knows there's all manner of testing and the treatment is completely different).  Best of luck with whatever you decide to do!

...and Blue, I'll update my diary shortly - it's been a hectic few days.
 

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Discussion Starter · #16 ·
Mandy - unfortunately $$ (or lack thereof) rule out coming to England for treatment. I think if our last funded treatment doesn't work, then we'll throw the rest of what we have into a donor egg cycle somewhere else in Europe.

Gosh, hearing from all of you has made me realise just how uninformed I am! I just went naively into treatment believing my doctor knew best and thinking it would work the first time.. if not, then it would definitely work the second time :-\

No other treatment protocol has ever been discussed or suggested. Actually last time I asked the doctor about short protocol for poor responders and he just shrugged and said it wouldn't make a difference :mad:

Thanks to you ladies I now have an extensive list of questions to take to the clinic tomorrow.
Top of the list is an AMH test and any others that might be relevant to my situation.
Second, what other protocols/medication could be tried.
Third.. why do i get NO response from my right ovary.
Fourth, how about monitoring me next time - I'm quite peeved about this one. I have never even had a baseline scan before starting stims.. only a date to start stims and a scan about a week later where the doctor sighs and tells me its not looking good (again). This latest cycle, my AF came late during DR and it wasn't quite over before I was due to start stims. I rang the doctor who told me it 'should' be fine (again, no scan). I'm convinced that this had something to do with this cycle being so poor - as well as not taking a break between cycles.
... and the list goes on.

You're all right.. getting this information is going to be really important for me now! I want to be fully prepared for the next round.

I'll let you know how the meeting goes tomorrow!

x
 

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Bluemaomao, I have very low amh and I'm taking 450 gonal + 150 menopur, + have just added ganirelix. I can't remember which protocol exactly, I think it's an antagonist/agonist protocol.  I hated it because you lose a month of trying because you have to do a prep month before but when I asked if I could change the consultant said without the prep month you get a lower yield- so of course I said "OK, I'll do it!!"  So far I've only got three follicles, but that is actually a good result for me.

I think you need to look into a clinic that is experienced with treating low responders otherwise you are just throwing your money away.  It's so not the case that any clinic will do.
 

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Discussion Starter · #18 ·
Thanks urbangirl - I'll take a look at that ganirelix. There are so many different protocols out there.

Well after yesterday's meeting with the doctor at the clinic I feel much better about things. It was a relief to finally get some information. Most importantly we got an answer about whether to continue trying with my own eggs after the next cycle or go for donor eggs... he said definitely donor eggs, which is what I knew all along.

At least now we know our options and can plan accordingly.

He said we might still be eligible for donor egg treatment (funded) here in Sweden. We thought we'd lost that chance after deciding to continue with my own eggs this cycle. If that happens, then we'll go on the waiting list (up to 12 months) and pay for one more cycle direct with that clinic (not through my own doctor).

If not, then we have one more free go. If that fails then we pay for donor treatment somewhere in Europe.

In any case, the next cycle will be short (flare) protocol. Getting a bunch of tests done next week and will be using summer to do as much research as possible on donor treatment.

Meanwhile we're treating ourselves to a last minute deal to Greece for a week, leaving tuesday. Yay!  :)
 

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Bluemaomao, I just wanted to add here that I've since found out that the Ganirelix was just to stop ovulation happening.  First time using it so i had no idea, it would be nice if clinics explained exactly what they were giving you stuff for!!.
My response has been terrible, from the 3 follicles only one egg from retreival, no idea whether it's going to fertilise or not, or whether they'll even let me cycle with just one anyway.  Sometimes clinics' focus on getting good stats means they don't always do the best for you, having good stats is more important to them to going ahead if they think you'll 'fail'.  Regarding stimms though, I had a better response when I was on just 75 units of Gonal, so now I think maybe high doses of stimms doesn't always mean better.
 

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Hi Urban Girl. I recently had tx and unfortunately got a BFN, we did short protocol which normally includes taking HRT the month before but I suffer from Hemiplegic Migraines and my GP had told me quite some time ago that he would not prescribe me HRT when i eventually go thru the menopause because HRT could cause me to have a stroke (Hemiplegic Migraines mimic stroke symptoms). I was really upset when I visited my GP for him to check my IVF prescription and he told me I would be taking a big risk if I took HRT.


Anyhow, our consultant said it was ok to just start with stimms and to leave the HRT out of the equation. He told me that it shouldn't affect my response. It didn't....I have AFC of 8....during stimms, 7 follicles responded and we got 5 eggs.


Different clinics give conflicting advice and I guess how we respond is very individual to us and can vary one cycle to the next. I will be doing tx again at the end of June after AF starts and will again be going without the months HRT prior.


Hi Blue - Im pleased to hear that your review went well. I know the ultimate dream is to get pregnant with OE, however, at least you know what the best course of action is. Good luck and I hope next time is lucky for you. I have considered DE if my OE don't work out for us. The way I see it is that it won't be my eggs, but it would be my womb that would give the baby life, my blood passing through it's veins and growing the organs....that would very much make it MY baby. Enjoy your holiday in Greece, it may be the last one you have for the next 18 years where you can do adult things  ^afro^
 
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